Friday, January 16, 2009


Sometimes I do not know whether I should laugh or cry when my satires become reality. Many times I simply shake my head when I watch my satirical prognostications become national news. But when my satirical targets strike closer to home, I am more inclined to cry.

I often ridicule insurance companies. I mock them in several ways. First, I target the strange tension between the extremely boring nature of their work and the pride their employees take in it. Second, I have a special hatred for health insurance providers because I believe that no person should be denied medical treatment for financial reasons. The fact that Americans depend on private employment (a scarce commodity even in good economic times) for their health insurance strikes me as fundamentally problematic. Even those with "good jobs" today find themselves embroiled in a new "reduced benefit world," in which private employers skimp on health coverage because it is "too expensive." This leaves already strapped wage-earners to buy health insurance by themselves--yet another large expense that they can ill afford (no pun intended).

Third, insurance companies thrive on jargon and doubletalk. I get many satirical ideas simply by reading insurance companies' advertising pitches and brochures. They dress up their language in cute phrases and empty technospeak that ultimately conveys nothing. All the while, I know that the only thing they want is your premium; and they will fight tooth and nail to deny your benefits when you need them. Fourth--and probably not last--I deeply resent insurance companies because they resort to any argument in order to avoid paying you money. In recent years, I have learned that insurance companies meticulously control their costs. Premiums give them a very healthy profit; paying out benefits cuts into that profit. To avoid paying benefits, insurance companies fanatically peruse contracts to find even the weakest grounds to justify themselves. They bring in lawyers to help them polish their maddening arguments. They look to see if your premium check arrived on the 17th instead of the 16th. They say that you had a "preexisting condition," namely, you are a human being with two legs, and the policy excludes coverage for "Bipedal Mammalopods" (see page 12263, Section 5A, Rider). In other words, insurance companies find a way to deny you. They even award bonuses to employees who find more effective ways to deny benefits to their customers.

In essence, insurance companies love taking your money. But they hate paying you, even though that is precisely what you bargained for.

I eschew traditional employment. Because I live in the United States, I need to either buy my own health insurance or go uninsured. I went uninsured for several years. Then I found out I had skin cancer on my head. I said "Self-pay!" on my way into the hospital. After a 60-minute operation under local anaesthesia, I found myself with a $20,000 bill in my hands. For the next year, I wrangled with borderline-deranged hospital "accounts professionals" who could not seem to comprehend the words: "I DO NOT HAVE THE MONEY TO PAY FOR THIS." After calling enough supervisors and supervisory supervisors, I convinced a relatively important bureaucrat that I should be made into a "charity case."

I did not want to go through that rigmarole again, so I started looking for private health insurance. I found some decent coverage for "catastrophic" injuries. I filled out a long application. I mentioned all the illnesses I ever had, knowing full well they may turn me down for some "preexisting condition," like breathing or sneezing. But they did not turn me down. They offered me health insurance for $320.00 every two months. There was a $1500 deductible on some services, but the policy covered hospital stays and other high-dollar "health care items." I felt good to know that if some other malady struck me, the hospital collection thugs would not drive me bankrupt. Assuming, of course, that money would be on my mind if I were deathly ill.

Since obtaining health insurance, I have been quite healthy. I have only had one doctor's checkup. The insurance company, of course, sent me letters demanding that my "family physician" send them my medical records so they could determine whether I lied on my application. Despite their best efforts, they could find nothing to justify rejecting my claim. They paid the $200 bill. So far, then, I have paid far more to the insurance company than they have paid out for me. And that's just the way they like it.

I received a letter from the insurance company wishing me a happy new year. It thanked me for "my business over the past year." By "business," they referred to my bimonthly trip to the Currency Exchange in order to obtain a $320 money order, which I promptly send to the insurance company (they don't take credit cards or automatic online payments... anything to make you forget to send your premium). I read on: "At this time, we have evaluated our premium rates to ensure they are aligned with advances in the health care industry." Uh oh. Sounds like a rationale for something. In English, this sentence means: "We looked over what we're charging you to see if we can justifiably raise your monthly rate." I read on: "Due to combined inflationary trends in health care, all members with policies similar to yours are receiving a premium rate adjustment." The letter then listed my "new" premium amount: $387.50. That is a $67.50 increase, or 21%. In English, these sentences mean: "We want more money. You are fucked. Pay us more now. There is nothing you can do about it. It's in the contract. We wrote it."

Happy New Year to you, too!

They offered me several other "premium reduction options." They said I could "downgrade" my policy if I wanted to keep paying $320. If I did that, they said I would still have a "strong benefits package." Upon closer inspection, I noted that these diluted "strong benefits packages" require that I pay $5000 in deductibles to receive only 80% of my original coverage. In English, these sentences mean: "So you don't want to pay $387.50? That's fine. Pay $320 for a shittier deal AND obligate yourself to paying $5000 before we pay you a nickel when you break your kneecap. It's your choice. We'll take as much money as you want to send us. Just don't expect the same services."

I shook my head in disgust. Here was an insurance company acting just the way I describe them in my satires. That saddened me, because I always think that I am exaggerating reality in my satires. But here I saw that my exaggerations did not overplay anything. The insurance company was acting as I always say they do. They even used vacuous, condescending jargon. So who wrote this? I thought about writing a letter back thanking the author for his concern. But to no avail: The letter was signed "Blue Cross and Blue Shield of Illinois." That is not a person I could write to. Then I thought: "How did a company write a letter?" There must have been a human being who wrote it, because only human beings can write. "Wow!" I thought. "This insurance company is so advanced it has trained incorporeal entities to write detailed rate increase letters." That takes talent.

But what would an insurance company communication be without a trademarked advertising slogan? Sure enough, there it was at the bottom of the letter, in a very nice, tasteful font: Individual and Family Health Insurance... It Just Fits.™”

I thought I could improve on that slogan. So I took a pen and added an ellipsis, plus some new, commercially-accurate words: "Individual and Family Health Insurance...It Just Fits…In Your Ass™.”

Now that's a commercial message I can actually believe.

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